Nick Hilton watched in horror as his wife Jamie stepped backward and tumbled 12 feet down into a culvert, hitting her head hard on a boulder at the bottom. Looking down at his motionless wife, Nick knew she'd suffered a severe injury.
"I wasn't sure if I was screaming her name out loud or just in my mind," Nick told TODAY's Savannah Guthrie. "But I just kept screaming her name over and over again. As I looked down on her I realized I had to get down there as soon as I could."
Jamie Hilton, recovering from a brain injury. Doctors removed part of her skull and stored it in her stomach for 42 days to let her brain heal.
Nick picked her up she took a gasp of breath.
The couple had been fishing in wilderness of Hell's Canyon, along the border of Idaho and Oregon, and they were far from any help -- or roads. A boat took Jamie to an ambulance, which then met up with a helicopter that airlifted her to the emergency room at Saint Alphonus Regional Medical Center in Boise. In all it took three hours.
At the hospital, doctors told Nick that his wife's brain was badly injured and she had only a 50/50 chance of surviving. They told him that her brain was rapidly swelling and the only hope was to remove part of her skull to allow the brain to expand without being crushed against the hard, unforgiving bone. They stored the skull fragment in her abdomen for safekeeping.
That was back in June. Today the former beauty queen has almost no after-effects from her accident. She remembers little of what happened after stepping back to reel in the fish that her husband had hooked for her.
"You know, I don't remember much," the former Mrs. Idaho told Guthrie. "I remember he cast the line and handed me the pole. I remember the fish on the line and pulling back and that's it. I don't remember falling. I don't remember landing."
Jamie remembers waking up in the hospital room. "When I woke up I was surrounded by my family and Nick," she told Guthrie. "There was a great feeling in the room. A peace and a joy. I could feel their joy when I opened my eyes."
When Jamie Hilton woke up in the hospital, first she saw her family surrounding her and felt their love and joy. Then, she looked down and saw this in her abdomen... part of her skull, stored there while her brain healed.
Then Jamie started to explore the damage she'd sustained.
"I remember lifting my gown and looking down and just seeing this huge bulge in my stomach and thinking, 'Is this real?'" she told TODAY. "Obviously it was not a dream. They had put the skull in my stomach."
Jamie's surgeon, Dr. Thomas Manning, explained why they decided to store the piece of skull in her abdomen.
"The body takes care of it," he told TODAY. "The body keeps the bone sterile. And then when you're ready to put the bone back you have it right there."
And 42 days after the bone was removed, doctors reattached it to Jamie's skull with titanium screws. Then they sewed her scalp back together. Today there is an inch-long crop of hair covering the scars.
Turns out the procedure Jamie had is commonly used for patients with severe brain injuries.
When his wife Jamie was injured, Nick Hilton prayed that she would wake up -- whatever shape she would be in. Today, she's made a full recovery.
"It's relatively routine," explained Dr. Ted Schwartz, a professor of neurology at New York Presbyterian Weill Cornell Medical Center. "The surgery that Jamie had is called a hemicraniectomy. When there is severe trauma to the brain, the brain swells and the skull is a closed cavity. So when that swelling occurs, the pressure goes up inside the head and it can be dangerous.
"So we remove part of the skull - about 25 percent. And we then need a place to keep it. And there are a couple of different options, but one of the best options is to plant it in the abdomen. It is not only sterile, but it travels with you."
In fact, the very same procedure was used when TV anchor Bob Woodruff suffered a brain injury while covering the war in Iraq.
"Bob Woodruff had a hemicraniectomy done in Afghanistan and he was able to travel with the bone in his belly and then they could put it back in the United States," Schwartz told Guthrie.
Looking at video and photos of her husband cradling her body while they waited for help, Jamie started to tear up. "It's so touching to see Nick taking care of me," she told Guthrie.
Though she's healthy today, Jamie says the accident has made a lasting difference.
"We all face the morning and decide how we're going to handle today," she told Guthrie with a cracking voice. "I think the biggest thing that has changed is it's not really a decision anymore. I am so grateful the minute my feet touch the ground. I get to go make breakfast, take my kids to school. Things that seemed so mundane before are not mundane anymore. I am just so thankful and happy."
Linda Carroll, NBC News